前下方不安定性を呈した肩甲骨関節窩骨軟骨損傷の1例

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We presented a case of traumatic anteroinferior glenohumeral instability caused by osteochondral injury of the glenoid. A 42-year-old female who fell down in a motorcycle accident complained of her left shoulder pain and limitation of shoulder motion. Physical examinations revealed anteroinferior shoulder instability at normal position but not at abduction and external rotation. Radiographs revealed inferior subluxation of the humeral head at external rotation. T2-weighted MR images showed low intensity cord-like lesion in the joint cavity. After 5-month-injury, arthroscopic surgery was performed. Arthroscopic examinations showed subluxation of the humeral head and osteochondral injury at anteroinferior quadrant of the glenoid. The loose body that derived from detached cartilage existed in the axillar pouch. Articular surface of the humeral head was frayed. Bankart lesion was not evident. After removing the loose body and resurfacing the glenoid subchondral bone, the labrum was detached and glenohumeral ligament - labrum complex was repaired by the double bridging fixation method. Rotator interval closure was added as an augmentation. The shoulder was immobilized for 3 weeks. Active range of motion was started at 4 weeks after surgery. 6 months postoperatively, there was no pain and no instability. In the present case, it was considered that osteochondral injury of the glenoid was a cause of anteroinferior glenohumeral instability. Arthroscopic repair of the glenoid articular surface is an adequate procedure for osteochondral injury of the glenoid.
2009-07-27

前下方不安定性を呈した肩甲骨関節窩骨軟骨損傷の1例

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